Haitian immigrants to the U.S. face mental health issues

Among other factors, the general context of insecurity in Haiti continues to impact their mental health

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Haitian immigrants are experiencing great stress in the United States (US), and some are prone to mental illness as the political impasse and the worsening economic and security situation has pushed many to migrate in recent years. They are also confronted with the challenge of adjusting to a new culture in their quest for a better life.

Cultural belief systems, high cost of treatment, and lack of information are part of the obstacles they face, and seeking mental health care remains challenging and taboo for many who prefer to turn to religion or other means to address their mental health issues.

Victoire Paul, 42, mother of three, used to live in Florida. She moved to Delaware after her partner was murdered in January 2022, in downtown Port-au-Prince, Haiti. She left Haiti before his assassination on August 17, 2021, due to the political crisis – giving up her job as a cashier at the Office of Vehicular Insurance Against Third Parties (Office d’Assurance Vehicles Contre Tiers, OAVCT), a governmental institution responsible for car assurance in Haiti.

Haitian immigrants are experiencing great stress in the United States (US)…

“This transition is very complicated for me. The stress is mainly related to the difficulties of finding a job and transportation for me and my kids. I feel depressed and can’t sleep normally. Sometimes I cry at night,” she says.

Following the assassination of his partner, the school that Victoire Paul’s son attended in Florida offered him psychological help. For this mother of three, access to therapy was not possible due to financial constraints.

The situation is a little bit different for Olson Pierre, 48, who currently lives in North Miami. He left Haiti for the Dominican Republic after almost getting kidnapped. Later, he moved to the United States from the Dominican Republic. As an immigrant, he must adjust to a new lifestyle and culture while retaining a connection to Haiti. For him, what is happening in Haiti is also burdensome on Haitian immigrants living in the US.

And some are prone to mental illness…

“The feeling of helplessness makes you nervous and angry. When your loved ones call you and make you listen to the sound of heavy gunfire in Port-au-Prince while they are under the bed, it stresses you out,” he says. Living in the United States is very challenging for him. He acknowledges that he feels depressed sometimes. “It is a very stressful country, the United States”.

A wide variety of mental health problems including anxiety, depression, post-traumatic stress disorder (PTSD), substance abuse, and a higher prevalence of severe mental illness and thoughts of suicide have been detected among immigrant populations in the United States according to the American Psychology Association (APA).

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Alberta S. Honoré, 36, a mother of one living in Boston, has been dealing with severe feelings of depression since the passing of her father from COVID-19, two years ago. When her father was sick, she could not see him because of hospital protocol to avoid the propagation of the virus. Instead, the family had to say their goodbyes through a Zoom conference call before his passing. 

“He wanted to die in Haiti, and drew his last breath alone in a hospital room. We could not digest seeing him die like that,” she says.

Honoré still feels depressed and the situation in Haiti makes her depression worse.  To date, she has never seen a mental health specialist.

“It is a very stressful country, the United States”

– Olson Pierre

There is a lack of data regarding mental illness among Haitian immigrants living in the US due to a lack of studies, as well as the fact that most people do not reach out for help. 

More broadly, Black communities are 20% more likely to experience serious mental health issues compared to the general population.

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Dr. Guerda Nicolas, a Haitian American licensed psychologist based in Florida, who focuses her practice on children, family, and community well-being, says the problems that most affect Haitians are depression and schizophrenia.

Based on her observations, Haitian immigrants have three distinctive ways of describing their depression: pain in the body, relief through God, and the fighting of an insurmountable battle. Dr. Nicolas indicates that most of the terms used by the Western mental health sciences to describe mental health issues and mental illness don’t exist in the Haitian imaginary and culture.

The problems that most affect Haitians are depression and schizophrenia.

According to her findings, the word trauma does not exist in Haitian culture either. In creole, people use “chok lespri” to describe trauma. For depression and anxiety, Haitians largely use idioms or common phrases like “kè m sou biskèt” (I am on pins and needles), “tèt mwen cho” (I am overwhelmed), “kò m pa bon” (I don’t feel well), or “mwen dekouraje” (I am discouraged).

“We spent a lot of time in rural communities in Haiti to better understand the concepts used by Haitians,” she says.

Schizophrenia is also a serious problem among Haitians. Men are more affected than women and according to Dr. Nicolas, it is caused by a combination of genetics and environmental factors. “People with schizophrenia often hear voices in their heads. They cannot discuss with people for too long. They cannot keep a job for a long period and refuse to sit in on social activities. They prefer to stay isolated”.

The word trauma does not exist in Haitian culture either.

Jinia Williams, a licensed therapist and director of the Mental Health Program at Sant la, assists Haitians who are dealing with trauma in Florida. At Sant La, they help children who are born with or face different types of traumas such as sexual trauma, physical abuse, car accidents, and community trauma. 

Sexual trauma among children mostly comes from rape experiences perpetrated by family members. Community trauma refers to traumatic events that can happen in communities such as gun violence in the US, gang violence, and civil unrest in Haiti.

“When mass shootings happen in the US, the children are traumatized and some don’t want to go back to school,” she says.

Williams indicates that the Haitian community is dealing with a lot of issues such as natural disasters back home, COVID-19, language barriers, living with strangers, and scams that target Haitian immigrants, stripping them of their means. All of these factors create more trauma and mental health issues. Haitian migrants who crossed the border last year also exhibited symptoms associated with depression and anxiety.

Sexual trauma among children mostly comes from rape experiences perpetrated by family members.

“They left someone behind. They have to deal with separation and new adjustments in a new country. Some adults were raped in the forests. When they share their stories, it is really sad,” reveals Mrs. Williams.

Haitian immigrants face many challenges and barriers that prevent them from seeking help. All three mental health specialists contacted by Ayibopost, point out that most of them don’t reach out for help when facing mental illness or mental health issues. It is partly due to cultural belief systems, financial limitations, lack of knowledge, and a lack in facilities to accommodate those who need intensive and long-term treatment.

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Dr. Stéphane Degraff, a psychiatrist in South Florida, affirms he receives more patients from the Latin community and Native American community. According to him, Haitians come to seek mental health support when their family tells them to or after being brought in by law enforcement to emergency rooms for behaving strangely in public. “When Haitians have been brought in by police, they were delusional and paranoid or had hallucinations and they needed treatment. Sometimes they experienced psychotic breakdowns,” he says.

Not only do they have difficulty sticking to the treatment required for recovery, but they also have mystical beliefs according to Dr. Degraff. 

“A lot of time the patient has gone to the psychiatrist, received treatment for depression, and still believes a neighbor in Haiti is trying to kill them.”

For Dr. Guerda, the cultural belief system is a blockage for members of the Haitian community to seek treatment for schizophrenia, for instance. The fact that this illness is also genetic makes it very difficult for the family to accept it.

Haitians come to seek mental health support when their family tells them to or after being brought in by law enforcement…

“Sometimes people think it’s a spirit (like loas, which are spirits in Haitian Vodou) that did something to their loved one.” 

The other barrier Haitian immigrants face is the high cost of treatment and lack of facilities for people dealing with mental health issues. The median cost for psychotherapy treatment varied between $100 to $200, with an average of $130 at the national level, for a 50 minute session in 2018. A person in Florida needed $125 per therapy session, with the median cost in Miami at $200 in 2018. In New York, it also cost an average $125 per session. Furthermore, in some cases, therapists are less likely to accept insurance compared to other physician specialties.

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Only 28.1% of Americans live in neighborhoods with mental health services that meet their needs and there is a lack of medical coverage for serious mental health illnesses compared to Medicaid plans. Both Dr. Guerda and Dr. Williams mention the lack of public residential placement facilities for people struggling with mental health illnesses in Florida. 

The Office of Veteran Affairs (OVA) is only for veterans who were in the army and there are some floors in some hospitals for people who have a breakdown due to mental health issues.

Compared to other States, Florida is behind when it comes to mental health facilities. There is a mental health facility in Orlando, and it is private and cost prohibitive.

A new trend in the African American community is emerging where men are being encouraged to seek psychological help to address trauma. Williams says this does not yet exist in the Haitian community. “At Sant La, more Haitian fathers assist the therapy sessions with their children. They know the importance of therapy, but they don’t reach out for help,” she states.

Furthermore, in some cases, therapists are less likely to accept insurance compared to other physician specialties.

Olson Pierre is aware of how much stress he faces in the United States and still doesn’t feel the need to seek mental health care.  “For us who come from Haiti, talking about mental health issues is a little bit taboo”, he says. To deal with depression he often goes to the gym, listens to music, reads, or rides a bike around his neighborhood.

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Victoire Paul, the mother of three, has yet to see a therapist one year after the assassination of her partner in Haiti. She relies on church and Facebook to cope. Alberta  S. Honoré acknowledges there is a need for her to seek psychological assistance, but never has time for it because of her busy life in Boston.

While the cultural belief system could be a blockage for Haitian immigrants to seek mental health care, Thomas A. Vance, PhD believes that culturally responsive mental health treatment can be one approach to tackling disparities when it comes to psychological wellbeing in the Black community. Dr. Degraff also mentions religion and meditation can make a difference in people’s lives.  

To reach for help when dealing with mental health issues, Haitians can contact the services below:

• In Miami, Dial 211 to talk to someone confidentially.  Services are available in Creole, Spanish and English. You can also get help by dialing  305-358-HELP (4357) or 305-631-4211.
• Consult the Sant la website to get more information about their mental health program: https://www.santla.org/ or call 305-573-4871 to make appointments or request assistance.
• Reach The National Suicide Prevention Hotline at 1-800-273-TALK (8255).
• For more information about mental health care resources and support, The National Alliance on Mental Illness (NAMI) HelpLine can be reached Monday through Friday, 10 a.m.-6 p.m. ET, at 1-800-950-NAMI (6264) or email info@nami.org.

Photo de couverture : © Christina Morillo